TORNA ALL’ELENCO

Food anaphylaxis: Data from registry of Center for Severe Allergic Reactions of Piemonte region (Italy) in Clinical and Translational Allergy

2011
AO Ordine Mauriziano

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (6)Vedi tutti...

Raie A

Mietta S

Heffler E


et alii...

Abstract

Background: Key challenges to the study of anaphylaxis are a lack of widely accepted standard working definitions, inadequate reporting of events, failure to agree on a severity threshold for classification as an anaphylactic reaction. Aim: To estimate the prevalence of food-allergy anaphylaxis based on the database of the Piemonte Region (Italy) Reference Center for Severe Allergic Reactions.The registry monitors a population of 4,400,000 inhabitants and collects data mandatory for prescribing self-injectable epinephrine reimbursed by Regional Health System. Methods: Anaphylaxis cases were diagnosed according to NIAID/FAAN criteria, and assigned to one of three levels of decreasing probability using a clinical checklist based on recommendations of the Brighton Collaboration. Results: Among the 1315 reported cases of anaphylaxis, 541 could be classified as food anaphylaxis, with level 1 (38%), level 2 (59%), and level 3 (3%) of probability. 212 patients were children (< 18yrs, age 7.4±5.4 yrs, M/F=2.0), and 329 were adults (age 35.5±12.9 yrs, M/F= 0.5). The main implicated food allergens were nuts (31%), egg (16%), milk (15%), fish (8%) and sesame (7%) in children and nuts (26%), vegetables (14%), crustaceans (12%), fresh fruit (10%), fish (7%), legumes (6%), seeds (6%) and flours (5%) in adults. Food-dependent exercise-induced anaphylaxis was reported in 28 patients. Skin and respiratory symptoms were reported respectively in 95% and 81% patients, with no differences between children and adults, while gastrointestinal symptoms were more frequent in children (43 vs 29%, p=0.001) and cardiovascular involvement was more frequent in adults (36 vs 16%, p<0 .0001). Conclusion: Food is an important cause of anaphylaxis, particularly in children (78.8% of all cases) with predominance in boys; this gender preference reverses in adulthood. Egg and milk were specific causes of anaphylaxis in children, while plant-derived foods and crustaceans were more specific in ad

Keywords

food allergen; epinephrine; allergen; anaphylaxis; food; allergic reaction; food allergy; register; Italy; human; child; adult; patient; nut; fish; checklist; milk; egg; Crustacea; monitor; prevalence; legume; fruit; plant seed; flour; skin; data base; vegetable; male; health care; sesame; population; gender; exercise; gastrointestinal symptom; boy; classification; adulthood; plant;